What's the best Auto CPAP?

[jps1012]

Hi... I currently have the Resmed M Series Auto Cpap. I am eligible for a new machine, whats the best Auto Cpap out now?


Also a side question, I use nose pillows and in the past If I tried to talk with the machine on air would rush out my mouth and the past few month I can talk fine with the mask on, is that a problem? Thanks!!

[Paul56]

Air rushing out your mouth with nasal pillows is normal and only an issue
if your mouth is open when sleeping because the effectiveness of the therapy
is significantly reduced basically to nil. Check your overnight leak numbers to
see if they are high.

Best Auto machine? I would not know these days. I suppose as back when I
was getting my machine... each system has its quirks and peculiarities so the
best is what will provide you as an individual with the best therapy.

I'm sure others will chime in on the machine recommendation.

[jps1012]

Air rushing out your mouth with nasal pillows is normal and only an issue
if your mouth is open when sleeping because the effectiveness of the therapy
is significantly reduced basically to nil. Check your overnight leak numbers to
see if they are high.

Best Auto machine? I would not know these days. I suppose as back when I
was getting my machine... each system has its quirks and peculiarities so the
best is what will provide you as an individual with the best therapy.

I'm sure others will chime in on the machine recommendation.

Thanks for the response... I guess my question was why did air rushing out when trying to talk stop happening.

[Pugsy]

in the past If I tried to talk with the machine on air would rush out my mouth and the past few month I can talk fine with the mask on, is that a problem?

No problem at all. Just means you have learned a little trick. I can yawn and not have the air rush out my mouth now as well as talk. It has to do with tongue placement. No big deal. You position your tongue to block the air from escaping and don't realize you are doing it.

Regarding the best APAP brand.

There are the 2 main contenders.. The PR System One Remstar Auto CPAP with AFlex..check my profile for link to it, and the ResMed S9 AutoSet. Either one is a great choice. Since you are used to a Respironics algorithm you might prefer the Respironics because it will feel the same to you. Both are very quiet.

ResMed machines have the new heated hose option which is quite nice but Respironics also is going to have a heated hose machine available very shortly.

ResMed offers more data on the LCD screen and Respironics still offers its pitiful 7/30 average AHI with no breakdown but that is easily remedied with easily obtained software.

Exhale relief is different in the 2 brands. You know about AFlex and CFlex...ResMed offers EPR which is a straight per cm drop in pressure during exhale.

DeVilbiss also offers a well thought of Auto cpap...entirely different algorithm than you are used to though. Software reports not quite as detailed as the others but really only missing wave form.

I have had a chance to use both the Resprionics System One machine and a ResMed S9 machine. To be honest...I like them both pretty much equally. My Respironics machine doesn't have a heated hose and I like a lot of added moisture and a cold bedroom. This winter I bought a stand alone heated hose that can be used with any machine..so the heated hose thing is not an issue.

If you have a chance to test the different brands to see if you happen to like the "feel" of one over the other that would be wonderful but if not....I suspect either would work well and do a good job for you.
The Resmed machine might be a teeny tiny bit more quiet in motor sounds but the difference was really too small to be measurable to my ears.

[jps1012]

Thanks a lot Pugsy!!! I really appreciate the detail. How much additional information on the screen does the RESMED show? Would I be able to see my daily leakage or would I still have to send the card to my sleep doctor? Thanks again!

[squid13]

You can see your daily leakage on the S9 AutoSet machine screen.

[Pugsy]

You can use SleepyHead software and see a huge amount of detail past what is shown on either brands LCD screen.
Check my signature line for more information.
But if software is not going to be used (though it is so easy don't know why you wouldn't) the Resmed S9 offers more details on the LCD screen. The leak shown on the LCD screen is a 95% number though..just means for 95 % of the time you were at or below that number.

[avi123]

[quote="jps1012"]Hi... I currently have the Resmed M Series Auto Cpap. I am eligible for a new machine, whats the best Auto Cpap out now? [quote]

A year ago I started with S9Elite which is a fixed CPAP. Three months later I purchased a S9 Autoset which is an APAP, hoping to benefit from the Auto feature. But I regret buying this APAP b/c I find it a poor OSA treater. It could be acceptable as a temporary diagnoser but that's about all since after you get your optimized pressure on it, I would switch to a fix CPAP to be set with this pressure. Also, there are lots of underlying medical conditions that should NOT use any APAPS. So my choice at this time would be a BiPAP or an ASV. This is also the latest recommendation by Dr. Barry Krakow for most XPAP users.

With this regard see also my comment to the poster Janknitz here:


http://maskarrayed.wordpress.com/2011/0 ... omment-615

[Pugsy]

Also, there are lots of underlying medical conditions that should NOT use any APAPS. So my choice at this time would be a BiPAP or an ASV.

If someone already has an APAP and using APAP I doubt there are any underlying physical problems to prohibit APAP use.

BiPap....especially useful if RX pressure is rather high..more exhale relief and thus more comfortable.
BiPap is Respironics term for a bilevel machine that offers separate settings for inhale and exhale pressure.
CPAP or APAP starts with a single fixed pressure and in auto mode that fixed pressure can vary.
VPAP is ResMed brand name of bilevel machines.
BiPap has sort of become a generic term even though it is brand specific to Respironics.
BiLevel machines can be fixed bilevel or variable bilevel (autos).
They cost more money and sometimes the doctors won't go for them unless there is a problem.
They are pretty sweet though. I recently got one and I wouldn't give it up for anything.
Normally one cannot buy a BiLevel machine with a cpap/apap RX. It needs to state Bilevel...even for the plain bilevel machines that don't qualify for ASV.
Bummer...but they do cost more...

ASV machines...bilevel machines that have a timed backup and some other fancy adjustments and settings. Well these are extremely costly and require another titration to be optimally adjusted. Insurance often squawks at the cost and could present a problem. These machines are designed more for those people with a high central apnea or complex apnea level of events.
Though Dr Krakow says he has good results treating plain jane OSA or UARS with them. It is not yet common medical practice though. Most docs won't go for it and neither will most insurance. $3K to 5K even on line...more through DME. Cost prohibitive for most of us.